Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
If you feel that something disturbing is happening with your heart, see a cardiologist. Sometimes even measuring blood pressure regularly is not enough. It turns out that it is necessary to perform more specialized tests.
ECG recording by the Holter method
This examination allows for many hours of recording of the ECG record under the conditions of normal activity of the patient.
Objective: To assess the electrical activity of the heart. Registration of rhythm and conduction disturbances. Assessment of abnormalities in the blood supply to the heart muscle. Evaluation of the starter operation.
Preparation: There is no need to perform any other tests, sometimes it is advisable to present the last ECG.
The doctor sticks electrodes on the chest, which connects cables with an ECG recording device. The device is attached to a belt so that the subject can move freely. When wearing the Holter, make a note of the most important activities and ailments, with the exact time.
The recorder is usually worn for 24 hours. During this time, it is not allowed to bathe, use electric pillows, blankets, and cell phones. It is also inadvisable to pass through gates (e.g. in shops). The test result is provided in the form of a description with attached charts.
Contraindications: None. It can be repeated many times. Performed on patients of all ages.
Prices: The examination is performed at the request of a doctor. In a private clinic: PLN 100.
coronary angiography
It is an invasive examination of the coronary vessels through a catheter inserted through the femoral artery into the heart and surrounding vessels. Through the catheter, the so-called contrast, which makes it possible to take pictures of blood vessels.
Aim: To assess atherosclerotic changes in the coronary vessels, the appearance and function of the heart valves, the ability to pump blood and the pressure in the heart chambers. Assessment of bypass patency and the risk of a heart attack in people after a heart attack or with a damaged heart muscle.
Preparation: 6 hours before the examination, do not eat. The patient is given sedatives (not to sleep) and antibiotics to avoid infection.
The test is performed lying down. The doctor introduces the so-called the vascular sheath, and through it the catheter, which leads through the aorta to the heart. The vascular sheath is removed either immediately or a few hours after the examination. The appropriate tip of the catheter provides access to the individual coronary vessels. Then the contrast is injected and X-rays of the coronary arteries are taken, which are then tapped onto a plate. The cardiologist, after assessing atherosclerotic changes, qualifies the patient for conservative treatment or angioplasty (PTCA).
After the procedure, you should stay in bed for about 6 hours, keeping the leg straight.
Contraindications: Lack of the patient’s consent, severe circulatory failure, severe arterial hypertension, allergy to the contrast medium, low blood potassium levels, fever, renal failure, hyperthyroidism, use of oral anticoagulants, recurrent severe arrhythmias, severe anemia.
The test is performed at all ages. It can be repeated.
Prices: It is carried out on the recommendation of a doctor, in a hospital setting.
Stress test
This test forces the body to work more, while monitoring the ECG and controlling blood pressure. In people with coronary artery stenosis, there is a critical level of exercise load beyond which it is impossible to deliver oxygen adequate to the required amount. Thus, the features of cardiac ischemia appear on the ECG.
Objective: To assess the physical capacity of the body, mainly the cardiovascular system. Diagnosing the effectiveness of the treatment of coronary artery disease. Also used in rehabilitation (after a heart attack).
Preparation: The ECG result should be presented. Immediately before the test, the patient should not smoke, eat, drink strong coffee or tea. You should consult your doctor about taking medications.
The test is performed on a bicycle ergometer or on a treadmill. Electrodes are glued to the patient’s chest and connected to the ECG machine, and a blood pressure cuff is placed on the arm. The exercise test on an ergometer is a gradual increase in load while maintaining a constant speed. In the case of a treadmill, the exercise test consists in increasing the speed of the belt and increasing the angle of its inclination. The test is stopped when the age-specific heart rate is reached, symptoms develop, or ECG changes that force you to terminate the test. The result is presented in the form of a description with graphs. The test takes several minutes. After the examination, it is recommended to rest.
Contraindications: Acute myocarditis, fever or flu-like disease, heart failure, frequent attacks of arrhythmias, unstable coronary artery disease, uncontrolled hypertension, orthopedic or neurological changes, hyperthyroidism. The tests are not performed on fragile, elderly or very sick people. The test may be repeated many times.
Prices: Performed on the orders of a doctor. In a private clinic: PLN 110.
Echocardiography
Also called the echo of the heart. It is a pictorial method of examining the heart and blood vessels using ultrasound. The image resulting from the reflection of the wave sent from the camera head appears on the monitor screen.
Aim: To assess the anatomical structures of the heart, its movement and intracardiac valves. Assessment of blood flow within the atria and chambers of the heart, large blood vessels and coronary vessels. It is possible thanks to the use of various systems – one-, two-dimensional and Doppler echocardiography.
The first shows the cross-section of the heart in one plane only. Currently, it is practically not used anymore. The second allows you to get an image in two planes. The image is assessed in motion as well as after it has stopped in any phase of the heart’s work. After freezing the image, you can measure the thickness of the heart walls or the size of its cavities. It is also possible to assess the contractility of the heart muscle or the volume of blood ejected from the left ventricle during systole.
Doppler echocardiography is based on the registration of blood flow in the heart cavities and blood vessels. Changes in blood flow velocity are recorded in the form of the so-called Doppler spectrum. This notation is subjected to computer mathematical analysis. The obtained parameters enable the assessment of intracardiac shunts, stenosis or insufficiency of intracardiac valves. Most of the machines available today can use all echocardiographic systems simultaneously, which allows for a complete assessment of cardiac function.
Preparation: Before echoing the heart, an EKG and a chest X-ray should be taken. There are no special recommendations for preparation.
For the examination, the patient is placed in the supine position or on the left side with the upper body slightly raised. The doctor places the echocardiograph head in several specific places: the apex of the heart, the left or right parasternal area, the subcardiac fovea, the zygomatic fovea and, less frequently, the paravertebral, subclavian and supraclavicular areas. Sometimes a transesophageal test is performed to better visualize the heart structures.
The test result is provided in the form of a description with attached photos. The examination lasts from several to several dozen minutes.
Contraindications: None. It is performed at any age. It can be repeated.
Prices: Performed on the orders of a doctor. In a private clinic: PLN 100.
Text: Marta Lenkiewicz
Consultation: Dr. Anna Maria Wołodzko, specialist in cardiology of the second degree, internal diseases and infectious diseases,
Source: Let’s live longer
Read also: Cardiac arrhythmias
How to take care of your heart. See the video
Find out how to recognize a heart attack. See the video
See also: How to perform a heart massage?